Insurance Claims Process

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Insurance claims process & checklist.

If your home or business were damaged by water, wind, fire, or hail. You are probably wondering what do to after your loss. Is your insurance company going to cover your loss? Are you going to have to pay for it yourself?

Most people have an insurance policy on their property, that will cover damages from certain perils like wind and fire etc. as long as they are sudden and accidental. If it is damage that has happened for months or years it is likely not going to be covered. Especially if it is obvious neglect. However, in most circumstances, coverage is afforded, though usually underpaid.

After you have suffered a loss the first step is to discover your damages. This seems pretty obvious in the case of fire or water damage. Exterior claims are not always quite so easy to discover. After all, it is not likely that you get on your roof very often, inspect your gutters and the exterior of your windows. If you notice that your neighbors are getting new roofs you should probably get your property inspected as well. You can have a qualified contractor inspect your property for these damages. You can also hire a public adjuster to do an inspection for you as well. These inspections are usually done for free.

You will want to start keeping a claims journal. This should include what happened and when, who did inspections, who you spoke with, and collect every email and letter you receive regarding your claim.

After it has been determined that your property has been damaged. You will need to file an insurance claim with your insurance company. Most insurance companies have their claims department on their website. This is the easiest way to file a claim. Some even allow you to fill out the form on their website. You can also file the claim with your agent but we have found more often than not they will try to persuade you from filing a claim because they will lose out on commissions and bonuses if their "loss ratio" falls too low. This is an illegal practice but it continues to plague the insurance industry.

You will want to ask for a copy of your declarations page to be sent to you as well as a copy of your policy. This will help you know how much coverage you have on your property as well as inform you of your after loss duties. Your contractor can not help you with this it is against the law. A public adjuster can help you navigate your insurance policy. The most important part of the policy for you at this point is the after loss duties. This is buried in the policy it is usually located at near the middle or end of the policy. In general, the most important part of your duties is to mitigate your loss. This means to prevent any additional damage. If you have to wind damage and are missing shingles you should have a contractor tarp your roof and prevent any further damages from occuring.  It is important to not do any permanent repairs at this point because this will adversely affect the outcome of your claim.

Your insurance company is going to assign an adjuster to your claim. There are several types of adjusters there are staff adjusters who only work for the insurance company. There are Independent adjusters who still only work for insurance companies but work for many of them. Then there are public adjusters who work for you the policyholder.

Your insurance company will likely assign a staff adjuster or an independent adjuster to come to inspect your home. Your insurance company legally must do a complete inspection of your property. When you file the claim make sure that they know you want a licensed insurance adjuster to inspect your home and demand that the adjuster show you his license before he accesses your property. Why? This is because insurance companies are cheap and they will try to send adjusters that are not licensed. That is not what you were paying your premiums for. So ask for a licensed adjuster!

The adjuster should inspect the house with every type of claim interior and exterior if he does not do a thorough inspection of your loss note in your journal what was not inspected.

When the adjuster completes his inspection he will likely tell you what he found. Make sure to keep write down your conversation here as well. He will return and put together an estimate some adjusters will do this onsite some of them will go back and write their report and estimate back at their office. Regardless they should have a number for you in a couple of weeks.

If the adjuster did a good inspection and wrote a great estimate, and your contractor can do the work for what was offered. Then go ahead and get the work completed. Remember it is important to follow the scope of repairs as closely as possible. Save all of your receipts and invoices as these will need to be submitted to recover your full claim.

If the adjuster denied your claim after his inspection and your contractor does not agree with his findings you may want to consider getting the opinion of a public adjuster. It is pretty common that the insurance company adjuster is seeing your loss with rose-colored glasses courtesy of the shareholders at the insurance company. A public adjuster works on contingency so they are not going to waste their time on a claim with no merit, and will work to get you what you are owed.

If the adjuster grossly underpaid your claim for whatever reason. This is also a good time to consult with a public adjuster. Most insurance companies use an estimating software called Xactimate but they do not train their adjusters how to use it. This benefits their bottom line because their estimates are generally much less. The less your insurance company pays you the more money they make.

We provide this document as a free service however we understand that many contractors may provide this guide to homeowners to help in the claims process. We highly encourage this as the more educated you are in the claims process the more successful outcome you will have. If your contractor provided you with this form it is a pretty safe bet that they have your best interests at heart. For more information please visit or give us a call for a free consultation with a public adjuster today 855-262-7707